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Lipoprotein (a) as a risk factor for prosthetic heart valve thrombosis

Mahmut Yesin1, Macit Kalçık2, Emrah Bayam3

  • 1Department of Cardiology, VM Medicalpark Hospital, Ovacık, D100 Üstü No:34, 41140, Başiskele, Kocaeli, Turkey. mahmutyesin@yahoo.com.

Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs
|November 14, 2025
PubMed

Insights

Elevated lipoprotein (a) [Lp(a)] levels are significantly higher in patients with mechanical prosthetic valve thrombosis (MPVT). This finding suggests Lp(a) may be an independent predictor of MPVT and cerebrovascular accidents (CVA).

Area of Science:

  • Cardiovascular Medicine
  • Clinical Chemistry
  • Thrombosis Research

Background:

  • Lipoprotein (a) [Lp(a)] is a known risk factor for atherothrombotic diseases.
  • Lp(a) shares structural similarities with plasminogen, potentially impairing fibrinolysis and promoting thrombogenesis.
  • Elevated Lp(a) is implicated in various cardiovascular conditions.

Purpose of the Study:

  • To investigate and compare lipoprotein (a) [Lp(a)] levels in patients with mechanical prosthetic valve thrombosis (MPVT) versus controls.
  • To identify independent predictors of MPVT, including Lp(a) levels.
  • To explore the association between Lp(a) levels and a history of cerebrovascular accidents (CVA) in MPVT patients.

Main Methods:

  • A cross-sectional study involving 80 MPVT patients and 75 age/sex-matched controls with normally functioning mechanical prosthetic valves.
  • Plasma samples were collected for the determination of lipoprotein (a) [Lp(a)] levels.
  • Statistical analysis was performed to compare Lp(a) levels and identify independent predictors of MPVT, including logistic regression and ROC curve analysis.

Main Results:

  • Patients with MPVT exhibited significantly higher Lp(a) levels compared to controls (22 vs. 6.9 mg/dL, p < 0.001).
  • Elevated Lp(a), subtherapeutic anticoagulation, prior CVA, and low international normalized ratio were independent predictors of MPVT.
  • Lp(a) levels above 19.6 mg/dL predicted MPVT with 65% sensitivity and 71% specificity (AUC: 0.767).
  • MPVT patients with a history of CVA had significantly higher Lp(a) levels (42.0 vs. 21.1 mg/dL, p = 0.012).

Conclusions:

  • Elevated lipoprotein (a) [Lp(a)] levels are significantly associated with mechanical prosthetic valve thrombosis (MPVT).
  • Plasma Lp(a) may serve as an independent predictor for MPVT and related cerebrovascular events (CVA).
  • Measuring Lp(a) in patients with prosthetic heart valves could offer valuable risk stratification for PVT and CVA.

Keywords:
Lipoprotein (a)Prostethic heart valveThrombosisTransesophageal echocardiography

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